The following is a summary of “Ablative effect of mitomycin reverse thermal gel: Expanding the role for nephron preservation therapy in low-grade upper tract urothelial carcinoma,” published in the September 2023 issue of Urologic Oncology: Seminars and Original Investigations by Kaimakliotis, et al.

Evaluate the value of total ablation before UGN-101 and the ablative effect of mitomycin reverse thermal gel in patients with low-grade upper tract urothelial carcinoma (UTUC) who receive biopsy alone or partial ablation. Researchers looked at 15 high-volume facilities’ worth of UGN-101 treatment for low-grade UTUC patients. Initial endoscopic ablative procedures (biopsy only, partial ablative, or complete ablative) and residual tumor size (complete ablative procedures, <1cm, 1-3cm, or >3cm) were used to classify patients before UGN-101. 

Total or partial response requiring little mechanical ablation to clear the upper tract of evident illness endoscopically was used as the primary endpoint to measure the rendered disease-free (RDF) rate at first post-UGN-101 ureteroscopy (URS). After removing the individuals with the most severe cases of the condition, 116 were left for analysis. There were no significant changes in RDF rates between those who had complete ablation (77.0%), partial ablation (55.9%), or biopsy only (66.7%) during their initial URS (pre-UGN-101) and those who underwent biopsy only (66.7%; P = 0.14). 

RDF rates did not differ significantly (P = 0.17) based on whether or not the tumor had been entirely ablated (1 cm), partially ablated (1-3cm), or left untreated (>3cm) before UGN-101 was induced. According to the findings of the preliminary clinical experience, UGN-101 may be useful in the initial chemo-ablative cytoreduction of bigger-volume low-grade tumors that may not appear to be susceptible to renal preservation. More research is needed to determine an accurate measure of the chemo-ablative effect and to pinpoint clinical variables for patient selection.

Source: sciencedirect.com/science/article/abs/pii/S1078143923001291#abs0002